Effects of vestibular rehabilitation in the management of patients with and without vestibular migraine

xlomafota13 shared this article with you from Inoreader Effects of vestibular rehabilitation in the management of patients with and without vestibular migraine Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Oct 25:S1808-8694(21)00161-0. doi: 10.1016/j.bjorl.2021.07.011. Online ahead of print. ABSTRACT OBJECTIVE: Vestibular Migraine (VM) is the second most common cause in patients with vertigo. Patients with VM complain about vestibular symptoms during a headache attack or during the period between attacks. Vestibular Rehabilitation (VR), an exercised based therapy to treat dizziness and balance dysfunction has been shown to be effective in vestibular diseases. In this study, we aimed to assess the effect of VR for vestibular symptoms and quality of life in VM patients, and to compare the results with patients with vestibular disorders without migraine. METHODS: Sixty (60) patients who received VR treatment were divided into two groups: vestibular migraine group (30 patients) and non-migraine vestibular dysfunction group (30 patients). All patients received VR for 18 sessions and the program was complete d in 1.5 months. Pre- and post-treatment Dizziness Handicap Inventory (DHI) scores, Vestibular Disorders Activities of Daily Living Scale (VADL) scores, the frequency of dizziness and headache, and Computerized Dynamic Posturography (CDP) scores were assessed and compared retrospectively. RESULTS: With VR in both the vestibular migraine group and vestibular dysfunction group, DHI score, VADL score, the frequency of dizziness and headache scores significantly impaired. Post-treatment CDP results were higher than pre- treatment results for both patient groups. CONCLUSION: With VR, a significant improvement was observed in subjective and objective balance assessment measurement. Vestibular Rehabilitation must be considered in patients who do not benefit from medical therapy or have limited benefit. LEVEL OF EVIDENCE: Level III (evidence obtained from well-designed controlled trials without randomization). PMID:34799267 | DOI:10.1016/j.bjorl.2021.07.011 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Eating disorders: A neglected group of mental disorders in patients requesting aesthetic surgery

xlomafota13 shared this article with you from Inoreader Eating disorders: A neglected group of mental disorders in patients requesting aesthetic surgery Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Nov 2:S1748-6815(21)00489-7. doi: 10.1016/j.bjps.2021.09.080. Online ahead of print. ABSTRACT BACKGROUND: There is a lack of data concerning the prevalence of eating disorders in patients requesting aesthetic surgery in spite of a large body of literature on the psychopathology of these patients. This may mostly be due to insufficient diagnostic assessment instruments. Therefore, the aim of this study was to determine the prevalence of eating disorders and their comorbidities in patients undergoing aesthetic surgery. METHODS: The assessment of prevalence of the eating disorders as anorexia nervosa, bulimia nervosa and binge eating disorder as well as other mental disorders was performed with the Structured Clinical Interview for DSM-IV mental disorders (SCID), axis 1. RESULTS: 212 patients (198 females, 14 males), requesting different types of aesthetic surgery, were included in this stud y. Eating disorders had a current prevalence of 8.0% (17/212) and a lifetime prevalence of 11.3% (24/212). Anorexia nervosa was predominantly found in patients with breast augmentation [current: 7.4% (2/27); lifetime: 11.1% (3/27)] and rhinoplasty [6.3 (1/16); 12.6% (2/16)]. Bulimia nervosa dominated in patients with liposuction [10% (3/30); 13.3% (4/30)] and binge eating disorder in patients with abdominoplasty [current/lifetime: 10.8% (4/37)]. Levels of significance (p ≤ 0.002) were reached for prevalence of the eating disorders in above mentioned types of surgery, when compared to prevalence data of the general population (two proportion Z test for SPSS). CONCLUSION: Eating disorders are distributed according to a certain pattern in the different types of aesthetic surgery. Interestingly, the current prevalence of eating disorders (17/212) was comparable to that of body dysmorphic disorder (26/212). PMID:34799292 | DOI:10.1016/j.bjps.2021.09.080 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Is there a change in P300 evoked potential after 6 months in cochlear implant users?

xlomafota13 shared this article with you from Inoreader Is there a change in P300 evoked potential after 6 months in cochlear implant users? Via cortical auditory Braz J Otorhinolaryngol. 2021 Nov 10:S1808-8694(21)00182-8. doi: 10.1016/j.bjorl.2021.10.002. Online ahead of print. ABSTRACT OBJECTIVE: There are few studies on long-latency auditory evoked potential (P300) in people with hearing loss who use a cochlear implant. Central auditory system evaluation with behavioral and electrophysiological tests is believed to help understand the neuroplasticity mechanisms involved in auditory functioning after cochlear implant surgery. This study investigated the electrophysiological processing of cortical level acoustic signals in a group of 21 adult individuals with postlingual bilateral severe-to-profound hearing loss who were submitted to cochlear implant surgery. METHODS: Data were collected in three phases: pre-cochlear implant surgery, at cochlear implant activation, and 6 months after surgery. P300 measures were also registered during all phases. Tone-burst and speech stimuli were used to elicit P300 and were presented in free field. RESULTS: Mean P3 component latency with tone-burst and speech stimuli were 352.9 and 321.9 ms in the pre-cochlear implant phase, 364.9 and 368.7 ms in the activation phase, 336.2 and 343.6 ms 6 months after the surgery. The P3 component mean latency values using tone-burst at activation were significantly different from those 6 months after cochlear implant. They were also significantly different using speech, between pre-cochlear implant and activation phases. Lower P3 component latency occurred 6 months after cochlear implant activation with tone-burst and pre-cochlear implant with speech stimulus. There was a weak correlation between mean P3 component latency with speech stimulus and time of hearing loss. There was no difference in amplitude between phases or in the comparison with the other variables. CONCLUSION: There were changes in P3 component latency during the period assessed, for both speech and pure-tone stimuli, with in creased latency in the activation phase and similar lower results in the two other phases, Pre-CI and 6 months after CI use. Mean amplitude measures did not vary in the three phases. PMID:34799269 | DOI:10.1016/j.bjorl.2021.10.002 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Navigation and non-navigation CT scan of the sinuses: comparison of the effective doses of radiation in children and adults

xlomafota13 shared this article with you from Inoreader Navigation and non-navigation CT scan of the sinuses: comparison of the effective doses of radiation in children and adults Via oto-rhino-laryngologie J Otolaryngol Head Neck Surg. 2021 Nov 19;50(1):66. doi: 10.1186/s40463-021-00541-x. ABSTRACT BACKGROUND: The advent of 3D navigation imaging has opened new borders to the endoscopic surgical approaches of naso-sinusal inflammatory and neoplastic disease. This technology has gained in popularity among otolaryngologists for endoscopic sinus and skull base surgeries in both adults and children. However, the increased tissue radiation required for data acquisition associated with 3D navigation protocols CT scans is a source of concern because of its potential health hazards. We aimed to compare the effective doses of radiation between 3D navigation protocols and standard protocols for sinus computed tomography (CT) scans for both the adult and pediatric population. METHODS: We performed a retrospective cohort study through electronic chart review of patients undergoing sinus CT scans (standard and 3D navigation protocols) from May 2019 to December 2019 using a Siemens Drive (VA62A) CT scanner. The effective dose of radiation was calculated in mSv for all exams. Average irradiation doses were compared using a Student's T-Test or a Kruskall-Wallis test when appropriate. RESULTS: A total of 115 CT scans were selected for analysis, of which 47 were standard protocols and 68 were 3D navigation protocols CT scans. Among these, 31 exams were performed on children and 84 exams on adults. For the total population, mean effective dose in the non-navigation CT scans was 0.37 mSv (SD: 0.16, N = 47) and mean effective dose in the 3D navigation sinus CT group was 2.33 mSv (SD: 0.45, N = 68). The mean difference between the two groups was statistically significant 1.97 mSv (CI 95% - 2.1 to - 1.83; P < 0.0001). There was a sixfold increase in radiation with utilization of 3D navigation protocols. The ratio was identical when the pediatric as well as the adult subset of patients were analyzed. CONCLUSION: In our center , utilization of 3D navigation sinus CT protocols significantly increases radiation exposure. Otolaryngologists should be aware of this significant increase and should attempt to decrease the radiation exposure of their patients by limiting unnecessary scan orders and by evaluating 3D acquisition protocols locally with radiation physicists. LEVEL OF EVIDENCE: Level IV. PMID:34798901 | DOI:10.1186/s40463-021-00541-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Navigation and non-navigation CT scan of the sinuses: comparison of the effective doses of radiation in children and adults

xlomafota13 shared this article with you from Inoreader Navigation and non-navigation CT scan of the sinuses: comparison of the effective doses of radiation in children and adults Via Laryngologie J Otolaryngol Head Neck Surg. 2021 Nov 19;50(1):66. doi: 10.1186/s40463-021-00541-x. ABSTRACT BACKGROUND: The advent of 3D navigation imaging has opened new borders to the endoscopic surgical approaches of naso-sinusal inflammatory and neoplastic disease. This technology has gained in popularity among otolaryngologists for endoscopic sinus and skull base surgeries in both adults and children. However, the increased tissue radiation required for data acquisition associated with 3D navigation protocols CT scans is a source of concern because of its potential health hazards. We aimed to compare the effective doses of radiation between 3D navigation protocols and standard protocols for sinus computed tomography (CT) scans for both the adult and pediatric population. METHODS: We performed a retrospective cohort study through electronic chart review of patients undergoing sinus CT scans (standard and 3D navigation protocols) from May 2019 to December 2019 using a Siemens Drive (VA62A) CT scanner. The effective dose of radiation was calculated in mSv for all exams. Average irradiation doses were compared using a Student's T-Test or a Kruskall-Wallis test when appropriate. RESULTS: A total of 115 CT scans were selected for analysis, of which 47 were standard protocols and 68 were 3D navigation protocols CT scans. Among these, 31 exams were performed on children and 84 exams on adults. For the total population, mean effective dose in the non-navigation CT scans was 0.37 mSv (SD: 0.16, N = 47) and mean effective dose in the 3D navigation sinus CT group was 2.33 mSv (SD: 0.45, N = 68). The mean difference between the two groups was statistically significant 1.97 mSv (CI 95% - 2.1 to - 1.83; P < 0.0001). There was a sixfold increase in radiation with utilization of 3D navigation protocols. The ratio was identical when the pediatric as well as the adult subset of patients were analyzed. CONCLUSION: In our center , utilization of 3D navigation sinus CT protocols significantly increases radiation exposure. Otolaryngologists should be aware of this significant increase and should attempt to decrease the radiation exposure of their patients by limiting unnecessary scan orders and by evaluating 3D acquisition protocols locally with radiation physicists. LEVEL OF EVIDENCE: Level IV. PMID:34798901 | DOI:10.1186/s40463-021-00541-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Three‐Dimensional Endoscopic Endonasal Surgery: A Systematic Review

xlomafota13 shared this article with you from Inoreader Three‐Dimensional Endoscopic Endonasal Surgery: A Systematic Review Via The Laryngoscope Objectives To compare participant performance and preference in the use of three-dimensional (3D) endoscopy compared to traditional two-dimensional (2D) endoscopy. Methods PubMed, Embase, Medline, ClinicalKey, BMJ Case Reports, and the Cochrane library were systematically searched for English-language articles published between 2005 and 2020. Studies reporting comparisons of outcomes between 3D and 2D endoscopes were identified. Data relating to performance-related outcomes, as well as the participants' preferred endoscope were extracted, and pooled using meta-analysis models. Results Ten studies were included in the qualitative synthesis. Six studies reported results of participants completing simulated tasks with endoscopes, while four reported full procedures. Peg transfer tasks (n = 4 cohorts) were found to be completed significantly faster with the 3D versus 2D endoscope (pooled mean difference 6.8 seconds, 95% confidence interval [CI]: 2.3–11.3), while no significant difference in times taken was observed for touch tasks (n = 4; pooled mean difference 3.7 seconds, 95% CI: −1.9 to 9.2). The secondary outcome of participant preference was reported by five studies, in which a significant preference for the 3D endoscope was observed (P = .010), with a pooled total of 72% (95% CI: 59–83) of participants preferring this to the 2D endoscope. Conclusions There is a growing body of evidence in support of 3D visualization in endoscopy. We have demonstrated 3D endoscopy to be associated with a significantly shorter time to performing simulated, reproducible and controlled tasks, and to be the preference of participants. This study provides grounds for further evaluation of the technology, and the potential for a greater widespread use. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A systematic review and meta-analysis of the effects of intraoral treatments for neurogenic oropharyngeal dysphagia

xlomafota13 shared this article with you from Inoreader A systematic review and meta-analysis of the effects of intraoral treatments for neurogenic oropharyngeal dysphagia Via swallowing exercises J Oral Rehabil. 2021 Nov 20. doi: 10.1111/joor.13274. Online ahead of print. ABSTRACT BACKGROUND: Rehabilitative treatments for oropharyngeal dysphagia, including oromotor exercises and sensory stimulation, have been widely adopted in clinical practice. However, the effects of these treatments are mainly supported by exploratory studies. As such, their clinical efficacy remains uncertain. OBJECTIVE: Our systematic review and meta-analysis aimed to evaluate the efficacy of int raoral treatments for neurogenic oropharyngeal dysphagia based on evidence from randomised controlled trials (RCTs). METHODS: Six electronic databases were systematically searched between January 1970 and July 2021. Data were extracted and analysed by two independent reviewers. The outcome measure was change in (any) relevant clinical swallowing-related characteristic. RESULTS: Data from 285 dysphagic patients were collected from 8 RCT studies across a range of intraoral dysphagia treatments. The pooled effect size of all intraoral dysphagia treatments was non-significant compared to control comparators (SMD [95%CI] = 0.23 [-0.22, 0.69], p=0.31; I2 =73%). Subgroup analysis revealed that the pooled effect sizes were also non-significant for oromotor exercises (device-facilitated lip resistance exercises and tongue exercises) (SMD [95%CI] = 0.11 [-0.76, 0.97]; p=0.81; I2 =88%) and sensory stimulation (thermal-tactile, thermo-chemical and electrical st imulation) (SMD [95%CI] = 0.35 [-0.03, 0.72]; p=0.07; I2 =0%). CONCLUSIONS: Our results showed that overall, intraoral dysphagia treatments, including oromotor exercises and sensory stimulation, do not show beneficial effects for neurogenic oropharyngeal dysphagia. The evidence for these treatments remains weak and currently inadequate to support clinical use. Large scale, multi-centre randomised controlled trials are warranted to fully explore their clinical efficacy. PMID:34800341 | DOI:10.1111/joor.13274 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.